New Patient Information

PAYMENT
We accept the following forms of payment:
CASH, CHECK, CREDIT/DEBIT CARD, CARE CREDIT
As the owner or appointed caregiver of the above-listed animal(s), I understand that by signing I agree to pay for the charges incurred by pet’s visit and understand that I must the pay the balance in full upon the discharge of my pet.

Photo Release

I grant Country Hills Pet Hospital the right to take photographs of my pet. I authorize Country Hills Pet Hospital to use and publish photographs in print and/or electronically. I consent to allow my pet's picture, case study, etc to be used for purposes such as publicity, blogs, and web content.

I have read and understand the above statements and any questions have been answered to my satisfaction by a staff member. I am the owner of the pet listed and authorize Country Hills Pet Hospital to use this information as needed.

Authorization for Care 

I hereby authorize the veterinarian to examine, prescribe for or treat the above-described pet(s). I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges must be paid in full, at the time of release of the pet.